The task of supervising the assignment of health care providers to hospital and other patients has often fallen to managers such as charge nurses or others without the aid of systematic tools or guides. In many hospitals and other facilities a nurse manager, charge nurse or other personnel with staffing responsibility may often manually fill out a schedule sheet to assign individual patients from patient lists to nurses, technicians and other clinical care personnel for a given shift, day or other period. That clinical manager may resort to informal rules, intuition and estimates concerning which care provider may be qualified, appropriate or available to service a particular patient. The clinical manager may informally take into account the patient's documented clinical condition such as acuity, age, the estimated workload represented by that patient and other indicators as well as the provider's own qualifications, training and clinical considerations including potential exposure to other infectious patients.
The task of appropriately tailoring care provider assignments to the needs of individual patients can become even more challenging since provider schedules may change significantly from day to day, for instance as nurses, technicians and others call out sick, change or overstay their shifts or take leave days. Patient assignments may likewise rapidly change as the patient population changes over the course of a shift, day other schedule period, or when the acuity or other status of patients themselves change. Because of these scheduling pressures and the improvised nature of assignments in many cases, the quality and appropriateness of the clinical match between a patient's provider team and the medical needs of that patient may be inconsistent or less than optimal over time. In general such manually generated assignments may not be systematically optimized or validated against clinical best practices or otherwise. In worst cases, a provider who is not qualified or competent to support a patient's clinical needs, for example a nurse not certified to operate a ventilator or pump, may be assigned to a patient requiring that type of attention. In other scenarios a care provider with recent potential exposure to infectious agents may be assigned to immune-compromised or other patients to whom they may act as a disease carrier. Likewise a patient representing a high workload commitment may be assigned to a provider whose capacity is already fully extended. Other problems in clinical workforce management exist.